How should we respond to Transgenderism?

Transgenderism, Gender Identity Disorder, Gender Dysphoria and Gender Incongruence are all terms that tend to get confused among people who don’t know much about these issues. My hope in this post is to help you better understand these terms, the ideologies and philosophies underpinning these ideas and how we should view them.

Definitions

First of all, transgenderism is the condition of someone not feeling like they are the same gender or sex as what they were at birth. Some definitions of transgenderism seem to include transvestitism which is the sexual fetish of dressing up as the opposite sex/gender.

Gender Identity Disorder (GID) is a Psychological disorder defined in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) as when an individual exhibits marked and persistent identification with the opposite sex and persistent discomfort (dysphoria) with their own sex or sense of inappropriateness in the gender role of that sex. This term was removed from the DSM in their 5th edition and was reclassified as Gender Dysphoria.

Gender Dysphoria is slightly different from GID because it focuses only on the discomfort (dysphoria) resulting from the persistent identification with the opposite sex. In this case, someone can be Transgender and not have Gender Dysphoria because they may not have any discomfort in their incongruence.

Gender Incongruence is a sexual disorder in the ICD-11 (International Classification of Diseases) which only deals with the incongruence between one’s biological sex and one’s gender identity. There doesn’t necessarily have to be any distress or discomfort accompanying. It is also not seen as a psychological disorder.

The Case for Transgenderism

Those who support transgenderism have a strong philosophical and scientific underpinning to claim that there are no problems with people identifying with the opposite sex or gender. However, different supporters of transgenderism have different views on gender and sex. Some claim that biological sex is a real phenomenon, whereas others claim that biological sex is socially constructed.

The case for why those people believe that sex is a social construct comes from the epistemological belief of constructivism. They argue that because there are so many biological variations between different sexes and that some characteristics typically associated with men can also be found in women and vice versa that the real distinction between men and women is not biological but nominal. They argue that the biological distinction between men and women are merely socially constructed categorisations and that there is no biological binary that clearly distinguishes men and women. They would argue instead that there is a biological spectrum between men and women and that an individual person wouldn’t perfectly fit into a male or female category but somewhere in-between. They would also apply this same idea to gender.

Gender is different from sex. While sex looks at the biological aspects of men and women, gender looks more at the social constructs surrounding what it means to be a man or woman. This is usually categorised as the difference between masculine and feminine. They point to anecdotal experience and show that there are masculine women and feminine men to show that there isn’t a perfect binary in social roles and that there is a spectrum between masculinity and femininity and thus the same with gender. It follows that because there is a natural spectrum with sex and gender that any variation on these spectrums is morally justified.

This may be a bit of a strawman and if there is a better way of representing this position, then forgive me and let me know in greater detail how I can frame it better. The scientific data also shows that helping people transition (providing Psychotherapy, hormone blockers or surgery) is effective at helping Gender Dysphoria. However, I want to look at how we can respond to this position.

The Response

To respond to this argument, let’s look at the philosophical framework in which this argument is being used. It either begins with the epistemic position of social constructivism. The belief of social constructivism suggests that the construction of knowledge does not come from the natural world (or that if it does, it’s very minimal) and instead comes from the development of social interactions. For this reason, ‘Truth’ is not objective, but what is seen as ‘true’ changes overtime as scientific methods change and societies develop.

However, the problem of subjective truth is that if the truth is subjective, then it can not be true. Something either is true or isn’t true. This is the Law of non-contradiction in logic. So, while social and scientific understanding of a subject may change and develop over time, this doesn’t, therefore, mean that the conclusions made by the society or scientific consensus are necessarily true but that it tries to best approximate the truth. The idea I’m defending is called Epistemological Realism. This idea argues that things exist in reality, independently of our particular perceptions. This means the best way we can understand something to be true is by corresponding our perceptions to the reality around us. It’s with this framework that I’ll respond to these arguments.

The first argument is that there is no binary in biological sex. However, this is simply not true. It is common knowledge in genetics that there are phenotypic sexes dependent on the X and Y sex chromosomes. This sex-determination system is not just for humans, but for most other mammals. There are rare mutations of these sex chromosomes which result in intersex conditions. However, these cases are the exception to the rule and don’t disprove the distinction between XX female and XY male sexes. From this phenotypic sex, there are natural variations that come from it amongst both men and women. The problem in the Transgender activist’s argument is that they believe these variations span across the two sexes. Some men have typically female characteristics and vice versa. However, these variations don’t happen across biological sexes but within them. These variations among men that are considered more or less masculine happen within the XY sex. The same is true for women where variations among women that are considered more or less feminine happen within the XX sex. There is simply no spectrum across the two distinct biological sexes. Otherwise, to argue reductio ad absurdum, humans don’t exist as a separate and distinct species because there are individual humans that have characteristics more or less like other species.

The second argument addresses gender theory. I think it’s rational to agree with the activists that there is a distinction between gender and sex. Gender tends to explain the differences between the sexes from a sociological perspective, such as the difference in perceived gender roles. I think it’s important to understand what we mean by gender roles. As an example, let’s take a hunter-gatherer tribe. In this tribe, the men are usually the hunter-gatherers simply because their sex is generally stronger, faster and thus more effective at providing food for the tribe. The women are usually less mobile due to pregnancy or raising children and are therefore more inclined to taking care of domestic life. From this reasonably simple example, we can see the distinction between sex and gender. The biological sex is distinct (but not inseparable) from the social roles the genders were playing. The gender role of the woman was the domestic child-bearer which is distinct from her natural ability to give birth. The role of the male was the hunter-gatherer which is distinct from his physical attributes of being stronger and faster.

However, in our modern society, there isn’t this dichotomy of gender roles. Many women have traditionally male gender roles by working and providing for a family, whereas many men have traditionally female gender roles of staying home and raising the children. There are a lot of sociological differences in gender roles, behaviours, and actions between the two sexes. However, I feel like there are some misconceptions. The basis of gender on masculinity and femininity makes a strong connection between social perspectives and biology, which greys the distinction. Masculinity and femininity can be linked to biological phenomena such as hormone levels, the neurological structure of the brain, and anatomy. This suggests that the basis of gender is much more grounded in biology than sociology. However, because of the natural variation within the sexes, it seems clear that men with some feminine characteristics will not wholly conform with all strict male gender roles because his biological masculinity is not entirely congruent with a masculine man. Likewise, with women. However, since the fundamental basis of sex makes distinctions between the two sexes. Likewise, the natural variations that can come with gender within each of the sexes suggest that these genders are still male and female. The variations in their behaviours, actions and roles are just variations within each gender and don’t cross between the two sexes.

So, what about gender identity? How do we explain people identifying with the opposite gender? To answer this question, we have to understand what identity itself is. Is identity the perception of oneself, or who one really is independent of their perception? I would argue as I did with my epistemic framework that one’s identity exists independently of one’s perception of it. People can indeed be mistaken about their own identity all the time, which suggests that the identity lies beyond the individual perception. This is why Gender Incongruence is, in my opinion, not merely a sexual disorder but a psychological one as well. If there is an incongruence between one’s psychological self-image and one’s identity, then the problem lies in the psyche, hence making it a psychological disorder.

So, what about the distress or dysphoria resulting from the gender incongruence? The current scientific literature favours transitioning to solve this issue. That the person with gender dysphoria should realign their secondary and in some cases, primary sexual characteristics to be more in line with their perceived gender identity. However, while this may solve the dysphoria, it doesn’t solve the underlying incongruence but merely encourages it. This is because not enough research has been done into desistence treatment. The two underlying theories of how to treat gender dysphoria are persistence and desistence treatment. Both have the goal of bringing one’s perceived gender identity to be congruent with their sex. Persistence treatment wants to bring one’s sexual characteristics to be congruent with their perceived gender identity. Desistence treatment wants to realign one’s perceived gender identity with their biological sex. Persistence treatment has a much stronger basis in current scientific literature, whereas desistence treatment has very little. Two points are usually raised to support the theory that desistence is a possible treatment. The first is the current scientific data showing that the majority of children diagnosed with gender dysphoria end up desisting[1]. The second is a singular case study showing a medication known as Pimozide being effective for desistence treatment[2]. These two studies indicate that desistence treatment is possible. While Pimozide may have only been effective in that single case, it doesn’t exclude the possibility that another drug could reverse the perceived gender identity to be congruent with their biological sex. I believe more research needs to be done in desistence treatment options to help manage both gender dysphoria and gender incongruence.

Why should we favour desistence over persistence treatment? Firstly, because the underlying philosophical claims made by those supporting persistence treatment are incorrect. Gender Incongruence goes beyond a man having feminine social characteristics. The man himself starts to identify with the opposite sex in order to make his body align with his psychological self-perception. The man could then experience many effects because of this incongruence such as body dysmorphia, dysphoria, delusions, as well as others. While the man may not experience any of those effects, these are real psychological problems that need to be addressed. This is why in order to solve both the dysphoria and incongruence, I find the desistence treatment to be a more effective solution.

Conclusion

Transgenderism is a politically tricky topic to talk about without understanding the underlying philosophy, sociology, and science around the topic. My aim was to present a response to the Transgender activists who have built a reasonable but ultimately unsubstantial basis for their beliefs. Hopefully, by reading this, you can come away with a greater knowledge of how to address this issue.